The Experience of Childhood Trauma and Its Influence on the Course of Illness in First-Episode Psychosis

Abstract

Persons with schizophrenia spectrum disorders often report high levels of childhood trauma, which often exacerbates symptoms and impede the process of recovery. However, little is known about how these traumas are experienced by service users and how they are integrated in their life stories. To examine this, we conducted in-depth interviews with 15 service users with a diagnosis of a first-episode nonaffective psychosis who had reported 1 or more childhood traumas in self-report measures. There was an unexpected discrepancy between the number of traumas reported in self-report measures and in semistructured interviews, and many of the traumas did not seem integrated in their personal narratives. The analyses further revealed that although participants often described complicated and traumatic childhood environments, they still felt supported by their families; they reported a range of ways in which they tried to cope with and gain control of their psychotic disorder, and they described a general optimistic view of the future.

Paradoxical outcomes in psychotherapy: Theoretical perspectives, research agenda and practice implications

“…By contrast, patients who integrated could be observed to work on making sense of such episodes. A similar process was noted by Jansen et al (2016) in a study of individuals who had experienced childhood trauma. In similar fashion to illusory mental health, an individual who coped with emotionally difficult memories by sealing over might appear, on a symptom measure to be 'well'.…”

Sources of Distress in First-Episode Psychosis: A Systematic Review and Qualitative Metasynthesis

“…As well as using substances, dilemmas regarding personal relationships (Jansen et al, 2016), seeking support or treatment (Connell et al, 2015; Tanskanen et al, 2011), and disclosing details about mental health difficulties (Connell, Schweitzer, & King, 2014) were described. For example, in this quote, the participant’s dilemma about taking medication appears to be a source of distress:I get depressed that I’m on an antipsychotic.…”

Childhood adversities: Social support, premorbid functioning and social outcome in first-episode psychosis and a matched case-control group

“…Children use their parents for support and most of the assessed adversities happened within the home-environment (Trauelsen et al, 2015), making it likely that these factors were associated. It may have been difficult to obtain support in an abusive and/or neglectful home environment (Jansen et al, 2015) and it is possible that there was a conceptual overlap between adult support and adversity. Adult support was correlated with number of adversities, post-hoc analysis: r s (93) = −0.44, p < 0.01.…”

“…It is plausible that childhood adversity that has not been dealt with and may even still be happening to some degree makes it difficult to see the family. A qualitative study of our FEP group actually found that some mention that it can make them feel bad to spend time with their family (even though they love them) (Jansen et al, 2015).…”